WWWTP#4 Answer

January 27, 2013

WWWTP


Answer to the WWWTP#4 posted on Jan. 14th:

The hardware on the femoral component is loose.  You can see a lucency in the proximal femur surrounding the proximal portion of the prosthesis:

knee-replacement-loose-2

The best XR you have in evaluating for hardware failure is a prior XR.  If you go back to the post on Jan. 14th you can see the comparison shows no lucency in this area and an obvious difference.

Other things to consider when looking at hardware:

1.  Is the actual hardware intact…no breaks

2.  Commonly screws will loosen or break

3.  Look at the cement around the hardware, has it changed?

4.  Look at the bones around the hardware, commonly small fractures will occur that can be difficult to see

For a crash course on types of hardware here is an interesting website from the University of Washington Department of Radiology:

ORTHO HARDWARE

Author:  Russell Jones, MD

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EMREMS: Radiology in Emergency Medicine

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